Arthritis

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ARTHRITIS

Arthritis is extremely common in older pets, especially the larger breeds of dogs. It can affect any joint, but the hips, shoulders and back are most common. Other conditions with similar signs are common as well.

Arthritis is progressive, becoming worse over time - sometimes quickly, but usually slowly and gradually. It may start as intermittent, occasional sore days, in very cold weather or with strenuous exercise. As it progresses, the lameness and stiffness become more frequent. It is usually worst when your pet first gets up after lying down and gets a little better as he or she moves around.

Other symptoms include decreased activity; reluctance to walk, climb stairs, hop in the litter pan or up on furniture, jump or play; limping; difficulty rising from a resting position; lagging behind on walks; soreness when touched; yelping, meowing or whimpering in pain; acting aggressive or withdrawn or other personality changes.

There are several other diseases and conditions that cause symptoms similar to arthritis, including intervertebral disc disease, spondylosis, ligament tears, and discospondylitis. It is important to have x-rays taken to be sure arthritis is really the problem. Other diseases require different treatment than arthritis. Discospodylitis, an infection of the bones of the spine, progresses quickly, causing irreversible damage in a short period of time. Early diagnosis is important if proper treatment is to be effective. If your dog hurts, your veterinarian will need to find out what's wrong as soon as possible.

Animals don't moan, whimper or stop eating until the pain is intolerable. There is no need for your pet to suffer from untreated arthritis or other conditions. Pain medications can be prescribed to keep your pet comfortable.

Some of the medications used for arthritis and other diseases are lifelong, especially the anti-inflammatory ones like Rimadyl© . Since these drugs can cause side effects, and since your pet will be on them for a long time, it is important for your dog or cat to have regular examinations and blood tests to monitor for such side effects, especially with liver and kidney function. Usually annual or semi-annual blood screening is recommended.

Arthritic dogs need regular, gentle exercise. Short walks are best. Over-exertion, as with fetching, Frisbee tossing or running, tends to aggravate arthritis, but slow walking or swimming is very beneficial. Two 15 minute sessions are generally better than one 30 minute one. Do not over-do on cold or hot days, as older pets are less tolerant of temperature extremes. Heart or respiratory disease and obesity decrease exercise tolerance. If your pet wants to stop, don't force him to keep going. If your pet is a hunting dog, you may have to force him to stop if he tries so hard he endangers his health. Some older pets are like older people - they don't want to admit they can't do the things they did in their youth.

Cats with arthritis may need to have their litter pan and food bowls moved to a more easily accessible location. Going up and down a flight of stairs is difficult and painful for an arthritic pet and many people put litter boxes and bowls in a basement, which not only requires stairs but also is damp and cool as well - conditions that worsen arthritis. Cutting down the side of the box to let the cat climb in and out more easily is also helpful. Potassium deficiency can cause weakness in cats, as can other age-related diseases. Trouble with stairs isn’t always from arthritis, so be sure your cat has a thorough check-up if symptoms appear.

To control obesity, ask your veterinarian for specific feeding recommendations. Older, inactive pets may only need half the calories they did when they were younger. Feeding appropriately and reducing weight increases activity. More exercise combined with less weight to carry around can reduce arthritis symptoms dramatically. Low levels of thyroid hormones and periodontal disease may also worsen arthritis in pets.

Arthritic cats and dogs are most stiff when they lay around, especially on cold surfaces. Encourage your pet to sleep on a bed or blanket and not on the cold, hard floor or ground. Pet sized waterbeds are available through pet supply catalogs and larger pet stores. These can be extremely beneficial to stiff, sore pets. Be careful with heating pads - even on low they will be uncomfortably warm for many pets and can cause severe burns. If your older pet likes to lie on one, be sure you always have at least two layers of towel or blanket between it and the pet and don’t leave any heating device on when you aren’t home.

Arthritis gradually worsens with time. Other diseases may progress at varying speeds and more than one may be present at a time. Your pet's activity level and medications will need to be adjusted as the months pass. Keep in close contact with your pet’s doctor so he or she can keep your pet as healthy and pain free as possible.

ARTHRITIS TREATMENT OPTIONS
The mainstay of arthritis treatment is a class of drugs called NSAIDs, for Non-Steroidal Anti-Inflammatory Drugs. These include aspirin, acetaminophen (Tylenol), ibuprofen, naproxin and many others used in both human and animal medicines. These drugs provide pain relief and many also reduce inflammation.

NSAIDs are wonderful drugs, providing pain relief and better quality of life for millions of pets and people. Unfortunately, NSAIDs can also have side effects. Gastrointestinal upsets are common, including stomach ulcers, vomiting and diarrhea. Kidney and liver problems can occur as well.

Newer anti-inflammatory medications have been developed over the past few years that minimize these side effects. Rimadyl and Etogesic are two brand names for pet medicines. Celebrex and Vioxx are two for humans. These newer drugs are more specific for the control of pain and cause fewer side effects. (Dogs and cats are not furry people. They don’t always process drugs and chemicals the way we do and the risks, dosages and side effects of medications are often different. Never give your pet a human medication without checking with your pet’s veterinarian first.)

If your dog or cat is stiff and sore, pain medication is needed and can greatly extend life expectancy and comfort. Ask your veterinarian for a recommendation based on your pet’s diagnosis and overall health. The doctor may recommend blood testing before or after beginning medication, to ensure liver and kidney function will be adequate to process the drug and that administration will be safe.

There are several newer treatments for arthritis that can be used in addition to anti-inflammatory medications. The following is a list of some of these products.

Arthroflex, Cosequin, Cartiflex, SynoviCre and many other brands of nutritional supplements that supply glycosaminoglycans. Found naturally in shellfish, mussels, and shark cartilage and other marine life, these nutrients are what the body uses to make joint fluid. Giving extra lets the body keep the joints better lubricated. Some brands also contain other nutritional ingredients that help the joints, such as chondroitin and creatine. About 2/3 of pets will improve on one of these - not every dog or cat will respond, and some do better on one product than another. It usually takes 2-4 weeks to see improvement. These supplements come in capsules, chewable tablets or granules to sprinkle on the food, and most pets like the taste.

Another nutrient your veterinarian may recommend is an Omega-3 fatty acid supplement. Fatty acids are present in most pet foods at low levels. Premium diets contain more fatty acids than grocery store brands. Extra amounts, above and beyond what is available in most pet foods, have anti-inflammatory effects, so they help relieve joint inflammation. They are also helpful for other chronic inflammatory diseases, including allergic skin disease and chronic kidney failure. As with the glycosaminoglycans, about 2/3 of dogs and cats seem to be helped by these. They take longer to show an effect, usually about 8 weeks.

A few manufacturers now make diets containing extra nutrients. These diets may be perfect for arthritic and large breed dogs. They contain high levels of fatty acids, so supplemental fatty acids are usually not needed. They also contain glucosamine and chondroitin, which have been shown to be beneficial to the joints. Providing fatty acids in the food may be less expensive than giving supplements, but the levels present in foods may not be high enough to have a therapeutic effect.

Adequan is a glycosaminoglycan, similar to the oral supplements mentioned above. It is given by injection instead of by mouth. For some dogs, the injections work better than the oral products. Adequan is injected intramuscularly twice weekly for four weeks. Not every dog or cat will respond to the medication. If they do seem to be improved, additional injections every few months may be needed to maintain the effect.

Palosein is another injection. It is a type of medication called a "superoxide dismutase". It works by scavenging molecules called free radicals and getting rid of them. Free radicals accumulate over time and contribute to inflammation.

Palosein is helpful about 60% of the time - it seems to help some dogs a great deal and others not as much. It is a series of injections given over a two-week period - daily for 6 days, then every other day for 8 days. It should not have to be repeated for two to three years, so this one series of injections lasts a long time. There are virtually no side effects from the medication, but it is somewhat costly and doesn’t always work.

Acupuncture is becoming a common treatment for arthritis and other diseases in pets. Your veterinarian may be able to refer you to a veterinary acupuncturist. Acupuncture really helps some pets a lot. There is usually an initial series of treatments at frequent intervals at first and then less frequently to maintain the effect.

Most of the treatments listed above are compatible with each other, so you can try any or all of them if you like. Most pet owners start with the nutritional supplements and then add other treatments if necessary. Ask your veterinarian if you have questions or want to try one of them. The goal with arthritis treatment is to keep the patient comfortable and active as long as possible. These new medications can help a great many dogs and cats stay happier longer.

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